Provider Demographics
NPI:1942680442
Name:COLLABORATORS, INC.
Entity Type:Organization
Organization Name:COLLABORATORS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SASHA
Authorized Official - Middle Name:P
Authorized Official - Last Name:VON KIBEDI VARGA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:847-446-7924
Mailing Address - Street 1:466 CENTRAL AVE
Mailing Address - Street 2:SUITE 27
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093-3041
Mailing Address - Country:US
Mailing Address - Phone:847-446-7924
Mailing Address - Fax:847-446-7924
Practice Address - Street 1:466 CENTRAL AVE
Practice Address - Street 2:SUITE 27
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-3041
Practice Address - Country:US
Practice Address - Phone:847-446-7924
Practice Address - Fax:847-446-7924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-01
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490085051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty